Title: Alternative Sweeteners

Hydrogenated Starch Hydrolysates and Maltitol Syrups 261
The American Dental Association (ADA) has recognized the usefulness of
polyols as alternatives to sugars and as a part of a comprehensive program including
proper dental hygiene. In October 1998, the ADA’s House of Delegates approved
a position statement acknowledging the ‘‘Role of Sugar-Free Foods and
Medications in Maintaining Good Oral Health’’ (12)
B. Laxation
The ingestion of HSH several times a day on an empty stomach of unadapted
subjects can result in a laxative effect. This is true of most polyols because of
their incomplete absorption and resultant increased osmotic pressure. This effect
increases with an increase in the relative amount of sorbitol in the HSH. In addition,
the digestive system appears to adapt with a decrease in symptoms such as
flatulence and diarrhea after repeated daily consumption (3). Persons in the 90th
percentile for consumption of lycasin-containing products only consume 1.1–2.6
g per day (13). It is recommended that if the ingestion of 50 g or more is foreseeable,
the statement ‘‘excess consumption may have a laxative effect’’ should be
used.
C. Caloric Content
The components of HSH are slowly and incompletely absorbed, allowing a portion
of HSH to reach the large intestine, thereby reducing the carbohydrate available
for metabolism. Therefore, unlike sugar that contributes 4 calories per gram,
the caloric contribution of HSH is not more than 3 calories per gram (14). For
a product to qualify as ‘‘reduced calorie’’ in the United States, it must have at
least a 25% reduction in calories. HSH may, therefore, be of use in formulating
reduced-calorie food products.
The lower caloric value of HSH and other polyols is recognized in other
countries. For example, the European Union has provided a Nutritional Labeling
Directive stating that all polyols, including HSH, have a caloric value of 2.4
calories per gram (15).
D. Suitability in Diabetic Diets
Control of blood glucose, lipids, and weight are the three major goals in diabetes
management today. Because of their slow and incomplete absorption, HSH have
a reduced glycemic potential relative to glucose for individuals with and without
diabetes (7). This property permits its use as a reduced-calorie alternative to
sugar. Doses of 45–90 g day are well tolerated without glycemic effect in either